Journal of Mind and Medical Sciences

Volume 2 | Issue 2 Article 4

2015

Toxicological Analysis of Some Drugs of Abuse inBiological SamplesAnne Marie CiobanuCarol Davila University of Medicine and Pharmacy

Daniela Luiza BaconiCarol Davila University of Medicine and Pharmacy, daniela_baconi@yahoo.com

Cristian BălălăuCarol Davila University of Medicine and Pharmacy

Carolina NegreiCarol Davila University of Medicine and Pharmacy

Miriana StanCarol Davila University of Medicine and Pharmacy

See next page for additional authors

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Recommended CitationCiobanu, Anne Marie; Baconi, Daniela Luiza; Bălălău, Cristian; Negrei, Carolina; Stan, Miriana; and Bârcă, Maria (2015)"Toxicological Analysis of Some Drugs of Abuse in Biological Samples," Journal of Mind and Medical Sciences: Vol. 2 : Iss. 2 , Article 4.Available at: http://scholar.valpo.edu/jmms/vol2/iss2/4

Toxicological Analysis of Some Drugs of Abuse in Biological Samples

AuthorsAnne Marie Ciobanu, Daniela Luiza Baconi, Cristian Bălălău, Carolina Negrei, Miriana Stan, and Maria Bârcă

This review article is available in Journal of Mind and Medical Sciences: http://scholar.valpo.edu/jmms/vol2/iss2/4

Toxicological analysis of some drugs of abuse in biological

samples

Anne Marie Ciobanu1, Daniela Baconi2, Cristian Bălălău3, Carolina Negrei2, Miriana Stan2, Maria

Bârcă1

1 Carol Davila University of Medicine and Pharmacy, Faculty of Pharmacy, Medicines Control

2 Carol Davila University of Medicine and Pharmacy, Faculty of Pharmacy, Department of Toxicology

3 Carol Davila University of Medicine and Pharmacy, Faculty of General Medicine, St. Pantelimon Hospital

Corresponding author: Daniela Luiza Baconi, e-mail: daniela_baconi@yahoo.com

Running title: Toxicological analysis for drugs abuse

Keywords: toxicological analysis, drugs of abuse, screening test, GCMS, HPLC, LCMS

www.jmms.ro 2015, Vol. II (issue 2): 108- 127.

Date of submission: 2015-03-11; Date of acceptance: 2015-06-17

Abstract

Consumption of drugs of abuse is a scourge of modern world. Abuse, drug addiction and their

consequences are one of the major current problems of European society because of the significant

repercussions in individual, family, social and economic level. In this context, toxicological analysis of

the drugs of abuse in biological samples is a useful tool for: diagnosis of drug addiction, checking an

auto-response, mandatory screening in some treatment programs, identification of a substance in the

case of an overdose, determining compliance of the treatment.

The present paper aims to address the needs of healthcare professionals involved in drugs

addiction treatment through systematic presentation of information regarding their toxicological

analysis. Basically, it is a tool that help you to select the suitable biological sample and the right

collecting time, as well as the proper analysis technique, depending on the purpose of analysis,

pharmacokinetic characteristics of the drugs of abuse, available equipment and staff expertise.

JMMS 2015, 2(2): 108- 127. Review

Toxicological analysis for drugs abuse

109

Introduction

Consumption of drugs of abuse is a scourge of modern world, regardless the fact that we are

talking about high-risk drugs or about the off label use of certain authorized medicinal products. It is a

large-scale, multifactorial, dynamic phenomenon which affects all the age groups, but predominantly the

one between 14 and 35 years old. Abuse and drug addiction, as well as their consequences are one of the

major problems in the current European society (1- 3). This is due to their significant repercussions in

individual, family and social level (crime, social marginalization, and death due to overdose or by

suicide) as well as in the economic level: dependence treatment costs but also the costs of the therapy for

viral and bacterial infections associated with the intravenous consumption (AIDS, HVC, or reappearance

of TBC) (4, 5). Given the major risks associated with the drugs of abuse, their analysis in biological

samples is a useful tool for:

- Initial diagnosis of drug addiction

- Checking an auto-response, a declaration

- Mandatory screening in some treatment programs

- Screening as a method of tracking drug effects over time

- Identification of the substance in case of an overdose

- Determination of treatment compliance

Discussion

Toxicological analysis represents the whole analytical processes through which the presence of a

toxic substance in an analysed sample is determined. It includes the physicochemical methods for the

isolation, identification and quantification of toxic substances in the air, water, soil, food, delict objects

and organic products for the prevention or diagnosis of intoxications (6- 9).

Drugs of abuse are those substances which, as a result of pleasant effects they produce, are used

for other purposes than the ones they are intended to. For example, the therapeutic effect in the

Toxicological analysis for drugs abuse

110

benzodiazepines case or the industrial use in volatile solvents case. Drugs of abuse are those substances

whose possession, transport or storage is restricted by law, due to potential harmful effect on the

consumer and include materials manufactured under license, as well as illicit products manufactured in

clandestine laboratories or natural products (10- 14).

The methodology of toxicological analyses of drugs of abuse is developed based on:

- Type of sample used

- Scope of analysis

- Pharmacokinetic features and biotransformation of the illicit substance

- Available equipment and reagents

- Staff expertise

- Costs.

Biological samples. Depending on the purpose of the analysis, the substances of abuse may be

determined from different biological samples.

Blood/plasma: first choice for the quantitative determination of drugs; therapeutic levels in the blood

are low but, when they are consumed abusively, the concentrations may be 2-3 times higher.

Urine: first choice for screening of drugs of abuse. It is available in sufficient quantity and substances or

metabolites are present in relatively high concentrations.

Hair: it is used for the determination of the history of an abuse substance consumption. Detection is

possible at10-14 days to 90 days after ingestion.

Saliva: it is used for the screening of drugs of abuse consumed within the last 24 hours.

Meconium: reveals maternal history of drugs of abuse consumption in the last 20 weeks of pregnancy

and allow the choice of therapy for mother and new-born.

Toxicological analysis for drugs abuse

111

Breast milk: it is used for the determination of the exposure extent of the infant to drugs of abuse.

For example, in table no. 1 are presented the chromatographic techniques used for the analysis of

methadone cited in the literature, grouped according to biological samples in which the determination is

carried out (15- 16).

Table 1. Chromatographic analysis of methadone according to the biological samples

BIOLOGICAL

SAMPLE GC-MS HPLC LC-MS

Plasma

Schmidt N. et al.,1992

Foster D. et al, 2001

Foster D. et al, 2003

Hallinan R. et al, 2006

Liang H.R. et al., 2004

Whittington D. et al., 2004

Etter M.L. et al., 2005

Lehotay D.C. et al., 2005

Rook E.J. et al., 2005

Quintela O. et al., 2006

Jenkins R. et al., 2006

Shakleya D.M. et al, 2007

Urine Larson M. et al, 2009

Moore C. et al., 2001 Cheng Y.-F. et al., 1999

Dams R. et al, 2003

Shakleya D.M. et al, 2010

Breast milk Choo R.E. et al, 2007

Jansson L.M. et al, 2007

Meconium Choo R. E. et al, 2005

Umbilical cord Nikolaou P.D. et al., 2008 de Castro A. et al., 2009

Placenta Nanovskaya T.N. et al., 2004

Saliva

Concheiro M. et al, 2010

Rodriguez Rosasa M.E. et al.,

2003

Ortelli D. et al., 2000

Hair

Moeller M.R. et al., 1993

Lucas A.C.S. et al., 2000

Girod C. et al., 2001

Kintz P. et al., 2009

Sweating Brunet B.R. et al., 2008

The detection time of abuse substances is varying in different biological samples. For example,

drugs of abuse are detected in saliva within minutes after consumption and in urine only after 4-8 hours

(17- 19).

Biological samples matrix is very complex and contains other endogenous or exogenous

substances in addition to substances of interest. This is the reason that, in most cases, is necessary to use

specific isolation procedures (20- 24).

Toxicological analysis for drugs abuse

112

Table 2. The detection time of certain substances of abuse in saliva and urine

Abuse substance Saliva Urine

Marijuana 12-24 hours Days/wk. Depending on the frequency of use

Opioid 12-24 hours 2-4 days

Amphetamine 24-48 hours 1-2 days

Benzodiazepine 24-48 hours 1 week

Cocaine 12-24 hours 2-3 days

Procedures for extraction of drugs of abuse from biological samples:

The liquid - liquid extraction (LLS): the method used for emergency analysis and for unknown analysis

when substances with physico-chemical properties must be extracted. This process facilitates the

extraction of a drug from aqueous solutions in organic solvents and involves a relatively high

consumption of solvents and multiple operations of extraction and separation.

Solid phase extraction (SPE): the aim of this method is the extraction, purification, and, sometimes, the

concentration of non-volatile or semi-volatile substances for analysis. It involves passing aqueous

solution through a column with silica based desiccant, active carbon and resins. It is a more expensive

process and often less sensitive (25- 29).

Testing of substances of abuse extracted from biological samples

The tests for substances of abuse shall be sub-divided into two types of analytical procedures:

- Screening tests: are quick, simple and requires a minimum previous processing of the sample.

Examples: immunoassays, Thin Layer Chromatography (TLC).

- Confirmatory tests: are performant, sensitive, selective methods that reduce the number of false-

positive / false-negative results. Examples: Gas Chromatography-Mass Spectrometry (GCMS),

High performance liquid chromatography (HPLC), Liquid chromatography-Mass Spectrometry

(LCMS).

Toxicological analysis for drugs abuse

113

1. Screening methods for the determination of drugs of abuse: thin layer chromatography,

immunoassay

For the toxicological screening of drugs of abuse simple, quick and inexpensive analytical methods

are required. Screening methods plays an important role in the forensic medicine laboratories, both in

the analysis of incriminated objects as well as in the analysis of biological samples. Due to the large

diversity of samples it is practically impossible to use extraction methods and sophisticated and time-

consuming instrumental techniques for analysis of all samples. Therefore, it is absolutely necessary to

use simple screening tests to restrict further research area (30- 33).

The conditions that have to be met by a method of analysis to be used as screening test:

- easy to performed

- quick

- not require a complicated and unaffordable equipment

- require few usual reagents

- not require highly qualified personnel

- inexpensive

- able to be performed also outside a lab

- require a minimum processing of the samples.

The interpretation of screening tests results is a complex process, which requires an overview on

limitations raised by the analysis method, by pharmacokinetic and biotransformation characteristics of

the incriminated substance, but also by psychological, physiological and pathological pattern of the

patient (including history of drug dependence) (34). A negative result does not necessarily indicate the

absence of the substance, that can be present but at a level below the detection limit of the method. A

true-positive result from a screening test will not indicate the dose, the time or the route of

administration, and it doesn’t make the difference between an occasional or a chronic administration.

That’s why, it is recommended to use more specific and performant analytical methods for confirming

the screening test results (35- 38).

Toxicological analysis for drugs abuse

114

Screening tests are used in several purposes: forensic (analysis of incriminated samples), clinical or

medical care (admission in substitution treatment, compliance of treatment, testing abstinence during

therapy), occupational medicine, doping tests. The most commonly used screening tests at the present

time are thin-layer chromatography (TLC) and immunoassays.

Thin-layer chromatography (TLC) is a wide spread technique used for the separation and

identification of substances. It is used to analyse bulk active substances, pharmaceutical products, but

also illicit substances or biological samples. Conventional TLC is a fast and low-cost method for

qualitative analysis. Requires a minimum and readily available equipment, and experimental techniques

are easily acquired. These determinations are not expensive, and can be carried out in laboratories with

limited facilities (39- 42).

The Committee of Systematic Toxicological Examination of the International Association of

Forensic Toxicologists (TIAFT), recommends 10 separation systems to identify medicinal substances

and drugs of abuse, depending on their acid-base character. The correspondence between the different

psycho-active substances and TIAFT recommended systems is shown in table number 5.

Table 5. TLC methods for the analysis of psycho-active substances according to TIAFT

Drug of abuse TA TB TC TE TL TAE TAF TAJ TAK TAL

5-methyltryptamine 56 - - - - - - - - -

amphetamine 43 20 9 43 18 12 75 - - -

benzphetamine 73 67 70 87 70 60 - - - -

benzoylecgonine 21 0 1 - - - - - - -

cannabidiol 94 - - 95 - - - 88 76 97

cannabinol 94 - - 95 - - - 90 77 97

cocaine 65 45 47 77 54 35 30 13 0 2

9- THC 11 - - 31 - - - 0 1 31

diamorphine 47 15 38 49 4 26 33 25 5 64

dimethyltryptamine 46 15 10 63 11 14 56 2 3 41

Toxicological analysis for drugs abuse

115

dimethyltryptamine 40 9 9 50 6 14 39 - - -

DOM 51 15 17 41 16 9 76 - - -

ketamine 63 37 63 79 64 68 72 47 4 43

lysergic acid 58 0 0 0 0 70 16 48 7 79

mescaline 20 3 10 24 12 6 63 2 9 51

methamphetamine 31 28 13 42 5 9 63 0 3 45

methadone 48 59 20 77 27 16 60 8 0 45

morphine 37 0 9 20 1 18 23 0 0 15

psilocin 39 5 9 47 9 14 48 - - -

psilocybin 5 0 - 0 0 80 1 - - -

Immunoassays are commonly used as screening tests for testing drugs of abuse. Often, they are

not making any discrimination between the related compounds, so the results obtained are likely to be

cross-reactive. For this reason, such methods are followed by confirmation using performant separation

technique such as GC-MS for qualitative analysis and HPLC for quantitative analysis.

Used on a larger scale, the immunoassays methods are based on the antigen - antibody reaction. The

quality of antibody is critical for the sensitivity, precision and accuracy of the determination. In order to

generate a measurable signal, the immunoassay technique uses a specific antibody for the identified

compound or class of compounds and a labelled form of the same compound or the antibody. The

labelling may be done with a radioisotope in case of radioimmunoassay (RIA), an active enzyme in case

of enzyme-linked immunosorbent assay (ELISA) or a fluorescent compound in case of fluorescence

immunoassay (FIAS) (43- 46). Polarization Immunoassay (FPIA) use fluorescein attached to one

compound (antigen) as marker. When it is bound to antibody, fluorescein molecular rotation slows down

and leads to changes in the polarization of fluorescent emission. The polarization p is inversely

proportional to the concentration of the unbound compound. The main advantage is the exceptional

stability of the FPIA reagents, which enable the tracing of the calibration curve valid for longer time and

the automation of the determination (47).

Toxicological analysis for drugs abuse

116

In the immunoassay methods, the biological sample requires a minimum previous preparation

(e.g. simple centrifugation in the case of urine). After the initial immunoassay test of the screening

program, usually we proceed to identify the particular compound involved using performant separation

methods from complex matrices as biological samples (48- 50).

2. Toxicological examination of the drugs of abuse - confirmatory methods

In order to eliminate false positive or false negative screening tests, toxicological analysis is continued

with confirmatory tests.

Confirmatory tests:

- Are effective methods, sensitive, selective, accurate, reproducible;

- Are performant column chromatographic methods: GC-MS, HPLC, LC-MS;

- Requires a laborious sample preparation stage;

- Requires expensive equipment and highly qualified personnel;

- Are analysed with higher costs.

Chromatography is a method of separating components of a mixture on the basis of their different

distribution between two phases, one of which is stationary - generally fixed on a support (glass or

aluminium plate, paper sheet, steel column, etc.) and other, mobile, which moves in relation to the fixed

phase. This conducted to a different migration of the components leading to their separation. The mobile

phase is gas in GC-MS methods and liquid in HPLC and LC-MS methods. The chromatography is used

both for qualitative and quantitative determination of the chemical substances. The identification is

based on the time required for the migration of the substance into the separation system. The assay is

based on the proportionality of the amount to the peak area (51).

Confirmatory Tests - gas chromatography coupled with mass spectrometry (GC-MS)

The GC-MS is the gold standard for a reliable identification of the drugs of abuse in all kinds of

samples. It combines the advantages of gas chromatography with those of mass-spectrometry. Mass

Toxicological analysis for drugs abuse

117

spectrometry is an analytical technique used to identify organic substances, based on pattern

recognition's of fragments resulting from the ionization.

Table 6. GC-MS methods for heroin and its metabolites analysis in biological samples

References United Nations

International

Drug Control

Programme

Goldberger B. A.

et al.

De Giovanni N. et al.

Wang W.L. et al.

Detected

compounds

Drugs of abuse Heroin, 6-acetyl

morphine

Heroin, cocaine and

metabolites

Cocaine, morphine,

codeine, heroin and

metabolites

Column Diffrent capillary

colum 12 m x 0,2

mm d.i.

Rtx-5, 15m x 25

mm d.i.

HP-1, 12 m x 0,2 mm

d.i.

HP-1, 12 m x 0,2 mm

d.i., film de 0,33 μm

Carrier gas He He ultrapur He

Flow rate 1,9 mL/min 1,2 mL/min 1 mL/min

Injection type splitless splitless

Injector

temperature

250°C 250 °C 250 °C 250 °C

Oven

temperature

150 – 300 °C,

with gradient of

12 °C/min

1 min. to 150 °C,

followed by

increasing to 200 °C

with a gradient of

12.5 °C / min,

maintained at 200

°C for 15 s,

increasing to 290 °C

with 30 °C/min,

held for 4 min

120 °C for 1 min,

increasing to 220 °C

with a gradient of 20 °C

/ min, then to 260 °C

with 5 °C / min and

finally to 280 ° C with a

20 ° C / min, held for 2

min

70 ° for 1 min,

increasing to 220 °C

with a gradient of 35 °C

/ min, constant at 220

°C 0.25 min, increasing

to 250 °C at 10 °C /

min, held at 250 ° C for

3 min

Derivatization SIM or TFA - BSTFA -1%TMCS -

Observation guide of

recommended

methods for

analysing

substances of

abuse

Heroin: LOD 10

μg/L; range 1,0 –

250 μg/L, r 0,995

6-acetyl morphine:

LOD 1,0 μg/L,

range 1,0 – 500

μg/L, r >0,995

LOD 50 ng/mL; range

50-500 ng/mL

Hair: range 0,1 – 10,0

ng/mg

Urine, saliva, plasma:

range 1 – 100 ng/mL

Extraction Liquid-liquid

extraction or SPE

with C18

cartridge

SPE with

ZSDAU020

cartridge

SPE with C18 cartridge SPE

Biological

samples

Blood, saliva and

urine

Blood, plasma,

saliva and urine

Urine Blood, saliva, urine and

hair

Toxicological analysis for drugs abuse

118

The mass spectrum recorded is compared with libraries of mass spectrum. In table number 6 are

listed a few GC-MS methods for heroin and its metabolites analysis in biological samples.

Confirmatory Tests – High Performance Liquid Chromatography (HPLC)

HPLC method is the first choise for the quantitative determination of drugs of abuse in all kinds of

samples. Quantitative determination is based on proportionality between peak area and amount of the

analyte in the sample. In Table number 7 several HPLC methods for analysis of the heroin and its

metabolites in biological samples are presented (52).

Table 7. HPLC methods for analysis of the heroin and its metabolites in biological samples United

Nations

International

Drug Control

Programme

United Nations

International

Drug Control

Programme

Katagi M. et al. Bourquin D. et al. Low A.S. et al. Umans J.

G. et al.

Detected

compound

s

Heroin and metabolites

(monoacetylmorphinae,

diacetylmorphine)

Heroin, morphine,

codeine and their

metabolites

Heroin, 6-

monoacetyl-

morphine,

codeine,

pholcodine,

dihydrocodeine,

morphine

Heroin, 6-

monoacetyl

-morphine,

morphine

Detection UV, λ=218nm Electrochemical Mass spectrometry DAD, λ=210 nm UV, λ=280 nm UV, λ=218

nm

Column LiChrosorb

60, 5 μm,

30cm x 4 mm

d.i.

ODS, 5μm, 25

cm x 4,6 mm d.i.

Capcell Pak SCX 1,5

mm d.i. x 150 mm, 5 μm

C18, 125 x 2 mm

d.i., 3 μm

Hypersil 3μm,

200 x 2 mm d.i.

LiChrosorb

Si 60 5μm,

30 x 4 mm

d.i.,

Faza

mobilă

acetonitril e:

ammonia:

methanol:

acetic glacial

acid soluţia

B

acetonitrile -

0.2M sodium

perchlorate

buffer / 0.005 M

sodium citrate

(1: 9, v / v)

10 mM ammonium

acetate (pH 6.0) -

acetonitrile (30:70, v / v)

o-phosphoric acid,

dicyclohexylamine,

acetonitrile, water,

dichloromethane,

pentane,

methanol,

diethylamine

acetonitrile,

ethanol

concentrate

d ammonia,

methanol,

glacial

acetic acid

Elution Izocratic Izocratic Izocratic Gradient Izocratic Izocratic

Flow rate 1,3 mL/min 1,9 mL/min 0.2 mL/min 0,4 mL/min 80 mL/ora

(1.33

mL/min)

Extracţie LLE or SPE

with C-18

cartridge

LLE or SPE

with C-18

cartridge

SPE ex SPE with C-18

cartridge

SPE with C-18

cartridge

LLE

Biological

samples Blood, saliva

and urine Blood, saliva

and urine Urine PLasma Urine Blood

Confirmation Tests - liquid chromatography coupled with mass spectrometry (LC-MS)

Liquid chromatography coupled with mass spectrometry is a modern hyphenated technique which

combines the advantages of HPLC with those of mass-spectrometry. The mass spectrum recorded is

Toxicological analysis for drugs abuse

119

compared with libraries of mass spectrum. It is used for both qualitative and quantitative determination,

having as advantages the selectivity and the increased sensitivity (53).

In table number 8 a few LC-MS methods for analysis of the methadone and its metabolites in biological

samples are listed (54).

Table 8. LC-MS methods for methadone and its metabolites determination in biological samples

References Vlase L. et

al.

Dams R. et

al.

Danielson T.J.

et al.

Widschwendter

C. G. et al.

Kelly T. et al. Rosas M.E. et al.

Detected

compounds

Methadone Opioids,

cocaine and

metabolites

Methadone and

her metabolites

(EDDP,

EMDP)

Methadone and

quetiapine

Enantiomers

of the

methadone

and of

EDDP,

EMDP

Enantiomers of the

methadone and of

EDDP

Detection MRM (310

→ 265)

SRM MRM MRM (m/z 310

→ 265; 384 →

253)

MRM SIM (m/z 310, 278,

313, 281)

Ionization ESI API ? API API ESI

Column Zorbax SB-

C18 (100 x

3.0 mm, 3.5

μm I.D.)

Synergi Polar

RP (150 x 2

mm, 4 μm)

? Waters

Acquity, C18

(50 x 2,1 mm,

1,7 μm)

AGP alpha-

glicopro-tein

AGP alpha-

glicopro-tein

Internal

standard

- Deuterated

isotopes of

the analysed

compounds

Deuterated

isotopes of the

analysed

compounds

D3-methadone - D3-methadone and

D3-EDDP

Mobile phase Acetonitrile:

0.2% formic

acid 45:55

(v/v)

Mixture of 10

mM

ammonium

formate or

0.001%

formic acid

and

acetonitrilein

various

proportions

Mixture of

acetonitrile and

5 mM formic

acid

20 mM acetic

acid:

isopropanol

93: 7 (v/v)

Acetonitrile:

ammonium acetate

buffer 18:82 (v/v)

Elution isochratic gradient gradient isochratic isochratic

Flow rate 1 mL/min 300 μL/min 0,25 mL/min 0,9 mL/min 0,9 mL/min

Column

temperature

45ºC 25ºC - - - 25ºC

Extraction De-

proteinized

plasma with

methanol

Urine diluted

with water

Without ? With

acetonitrile and

centrifugation

? ?

Biological

samples

Plasma

Urine

Urine Blood

Liver

Urine Hair Saliva

Toxicological analysis for drugs abuse

120

Conclusions

The methodology of a toxicological analysis of the substances of abuse shall be developed on the

basis of: test sample type, analysis purpose, pharmacokinetic and biotransformation particularities of

substance, equipment and reagents available, stuff expertise, cost.

Immunoassays offers a flexible approach of the analyses of drugs of abuse from different

biological samples and represents a convenient method and a quick screening test for a large number of

samples, with different matrixes. A true-positive result of an initial screening test, will not indicate on its

own the dose, the time or the route of administration and it will not make the difference between an

occasional administration or a chronic one.

Screening tests require subsequently performing confirmation tests for removing false positiveâ/

false negative results. Confirmation tests are modern chromatographic techniques (GC-MS, HPLC, LC-

MS), high-performance, sensitive, selective, accurate. Confirmation tests have as disadvantages: time-

consuming step for the processing of the samples, expensive equipment, highly qualified staff and high

cost.

The identification and the assay of drugs of abuse and their metabolites in biological samples

provides to the specialists (doctors, authorities in the field of health, representatives of law) an objective

tool for the diagnostic of abuse or for the monitoring of addictions treatment. Interpretation of the results

is a complex process and requires an overview of: the analysis method, pharmacokinetic and

biotransformation particularities of the substance, clinical pattern of the patient (including history of

drug dependence).

ACKNOWLEDGEMENT: This paper is supported by Sectoral Operational Programme Human

Resources Development (SOP HRD), financed from the European Social Fund and by the Romanian

Government under the contract number POSDRU/159/1.5/S/132395

Toxicological analysis for drugs abuse

121

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